Endoscopic Methods in Gynecology and Infertility: A comparison of experiences with culdoscopy and laparoscopy

Summary

Experience with 500 culdoscopic and 80 laparoscopic examinations was reviewed. Both procedures were found to be of substantial value in infertility diagnosis.

Laparoscopy provided a more extensive view of the pelvic contents, including the superior and anterior aspects of the uterus, and also the bladder, as well as upper abdominal structures. Culdoscopy seemed especially suited to diagnosis of abnormalities of the fimbriated ends of the tubes and the ovaries. This method was also better suited to obese patients. Laparoscopy, the more formidable of the two endoscopic methods, appeared better suited in cases in which the site of abnormality could not be localized on the basis of prior diagnostic measures to the ovaries and fimbria.

Thus, in diagnosis the procedures were complementary rather than competitive. Although biopsy could sometimes be performed to advantage, surgical procedures at the time of the endoscopic examination such as lysis of peritubal or periovarian adhesions or any type of fimbrioplasty were not found to provide lasting benefit. Other minor surgical procedures could be performed during either procedure by an experienced operator.

Among available diagnostic modalities, only laparotomy is more informative. Culdoscopy and laparoscopy are thus of great value to any physician concerned with the management of gynecological problems and infertility.

Key-Words

Culdoscopy - peritoneoscopy - infertility